November 8，The State Council's Reform Leading Group for Deepening the Medical and Health System Reform released the "Several Opinions on Further Promoting the Experience of the Reform of the Medical and Health System" (hereinafter referred to as "Opinions")，The file summarizes the 24 typical experiences since the 8 -year medical reform。

 

  The Office of the Central Committee of the Communist Party of China、The General Office of the State Council forwarded the Opinion，and issue a notification，Requires and regional departments to implement it carefully in accordance with the actual situation。

 

  Previous，Various regular press conferences of the National Health and Family Planning Commission often introduce successful experience in medical reform in various places，and promote the reference of all places，But it is a advocate requirement to learn，There is no rigid request for writing。

 

  This time，But summarize the mature medical reform experience in various regions into documents，and from the Central Committee of the Communist Party of China、Co -forwarding of the General Office of the State Council，It can be seen that these experiences have obtained the highest level of recognition，and rising into a policy that must be implemented in various places。

 

  The following is the 24 typical experience content mentioned in the Opinions:

 

   (1) Establish a strong leadership system and medical treatment、Medical Insurance、Pharmaceutical & ldquo; Three Medical & RDQUO; linkage work mechanism，Provide organizational guarantee for deepening medical reform

 

  1. Strengthen the leadership of the party committee and government for medical reform.

 

  Deepen the work of medical reform is responsible for the leadership of the local party and government at all levels。The main responsible comrade or a main responsible comrade of the party committee and the government as the leader of the leadership group of the medical reform，Give full play to the coordination and coordination of the leadership group of the medical reform，Effectively implement the government's leadership responsibility for medical reform、Safe liability、Management responsibility、Supervision responsibility。

 

  2. Establish a sound work promotion mechanism.

 

  Grabbing responsibility division of labor，Establish a reform task ledger system，Implement the responsibility layer in place。Grasp the supervision and implementation mechanism，Special inspection key reform tasks，As an important basis for annual evaluation。Grab the assessment accountability mechanism，Increase the completion of the medical reform tasks into the comprehensive deepening reform performance assessment and government target management performance evaluation，Areas and individuals that are not effective for reform and accountability for serious accountability，Active innovation in commendation and reward、Areas and individuals with remarkable results。

 

   (2) Break the medicine supplement with medicine，Establish and improve a new mechanism for running a new public hospital

 

  3、According to Teng Space、Tune structure、The basic path of the convergence is gradually rationalized medical service price。

 

   Actively and steadily promote the reform of the price of medical services，Make sure the public hospital is benign operation、Medical Insurance Fund to withdraw、Under the premise that the burden of the masses will not increase the overall，Control according to the total amount、Structure adjustment、There are ascending and downward、Gradual requirements，Category Guidance Stimulate the price relationship between medical institutions and medical service projects in different levels。All public hospitals cancel drug bonus，Coordinated consideration of compensation policies determined by the local government，Precise measurement price adjustment level，Adjust the price of medical services synchronously。Code for diagnosis and treatment behavior、Reducing the cost of getting medicine and consumable costs，Dynamic adjustment of medical services price。Price adjustment should focus on improving diagnosis and treatment that reflects the value of medical services in medical staff、Surgery、Nursing、Price of medical projects such as rehabilitation and Chinese medicine，Reduce the price of inspection and inspection of large medical equipment，Pay with medical insurance、Hierarchical diagnosis and treatment、Calculation control and other policies to connect with each other。Through comprehensive stake sports betting apppolicy，Stake Sports BettingGradually increase medical service income (excluding medicine、Consumption、Check、Test income) The proportion of total income in the hospital，Establish a new mechanism for running a public hospital。

 

  4. Implement the drug classification procurement of public hospitals.

 

  Different from drugs，Through tender、Negotiations、Direct network、fixed -point production and other methods to form a reasonable procurement price。Adhere to the principle of concentrated band purchase，Large clinical dosage、Purchase amount high、Basic drugs and non -patented drugs produced by many companies，centralized bidding and procurement by provincial drug procurement institutions。Comprehensive reform pilot cities of public hospitals can adopt the city as a unit to purchase on the provincial drug centralized procurement platform。Encourage cross -regional joint procurement and joint procurement of specialist hospitals。Implementation of medical consumables Sunshine Purchase，Carry out high -value medical consumables、Inspection and detection reagents and centralized procurement of large -scale medical equipment。For some patented medicines、Exclusive drugs，Create open and transparent、Price negotiation mechanism participated by multiple parties。The results of the negotiation are announced on the comprehensive management information platform of the National Drug Supply Guarantee，The hospital purchases medicines according to the results of negotiations。Do a good job of connecting with medical insurance payment policies，Incorporate the eligible negotiating drugs in accordance with regulations。

 

  5、Drug procurement of public hospitals gradually implemented & ldquo; two -vote & rdquo;。

 

  All places should adapt to local conditions，Gradually promoted drug procurement of public medical institutions & ldquo;，Circulation enterprises issue an invoice at a medical institution)，Encourage other medical institutions to implement & ldquo; two -vote & rdquo;，Reduce the intermediate link in the field of drug circulation，Improve the concentration of circulating enterprises，Strike & ldquo; Tickets for money laundering & rdquo;，Reduce drug virtual high price，Purifying and circulating environment。Integrating the warehousing resources and transportation resources through the integrated drug operation enterprise，Accelerate the development of modern drugs，Encourage regional drug distribution of urban and rural integration，Provide basic conditions for promoting & ldquo; two votes & rdquo;。Establish a blacklist system for commercial bribery companies，Pharmaceutical production and circulation enterprises that appear commercial bribes such as rebates，Cancel its supply qualification。

 

  6. Standardize diagnosis and treatment behavior.

 

  Using informatization means to outpatient for all medical institutions、Inpatient diagnosis and treatment behavior and expenses carry out full -time monitoring and intelligent review，Reminder beforehand、Control in things、Review afterwards。Carry out prescription reviews，Strengthen information disclosure and social supervision。Strengthen the monitoring of reasonable medication and adverse reactions，High price、Large dosage、Non -therapy Aids and other drugs establish a key monitoring directory，Carry out tracking monitoring、Ultra -Normal Warning。Key medicines can be picked up and purchased，Clear purchase quantity、Doctors who open prescriptions，After approval by the person in charge of the medical institution, it will be filed with the drug procurement department。Strictly control the scale of public hospitals with excessive growth。

 

  7. Implement the government's responsibility.

 

  Comprehensively implement the government's investment policy for public hospitals。According to relevant regulations，Gradually repay and resolve long -term debt of public hospitals that meet the requirements。

 

   (3) Give play to the basic role of medical insurance，Strengthen external restrictions on medical services

 

  8. Strengthen the management functions of the medical insurance office.

 

  Integrate the basic medical insurance system for urban and rural residents，Achieved coverage、Funding policy、Guarantee treatment、Medical Insurance Catalog、fixed -point management、Fund management, etc. & ldquo; six unification & rdquo;。Stimulate the management system，Unified Basic Medical Insurance Management，Pilots that can be carried out to establish a medical insurance fund management center，Undertaking fund payment and management，Drug procurement and expense settlement，Medical Insurance Payment Standard negotiations，Affairs management and settlement of fixed -point institutions，Give full play to medical insurance for drug production and circulation enterprises、The supervision and restriction of hospitals and doctors，Provide the starting point for the linkage reform。The unified medical insurance agency shall increase the efforts to promote the reform of the medical insurance payment method，Further play the control of medical insurance for unreasonable growth of medical expenses。

 

  9. Comprehensively promote the reform of payment methods.

 

  Gradually reduce payment by project，Promotion is mainly based on the type of disease，Promotion is mainly based on the type of disease，Pay at the first person、Pay on daily fees、Total payment method combined with a variety stake betting appstake betting appof payment methods combined with a composite payment method，Encourage the implementation of a group paid (DRGS) method according to the diagnosis of disease diagnosis，Gradually reforming medical insurance payment methods cover all medical institutions and medical services。Conditional areas can be managed with points and budget management、Pay according to disease species and other combination，Promote the orderly competition between medical institutions and reasonable allocation of resources。Establishing the balance of the balance、The incentive and restraint mechanism of reasonable overworthiness sharing，Stimulate the standard behavior of medical institutions、Endogenous power to control costs。

 

  10. Innovative basic medical insurance service model.

 

  According to the principle of separation of management office，Promoting the professionalization of medical insurance agencies。Under the premise of ensuring the security and effective supervision of the fund，Entrusted social forces such as qualified commercial insurance institutions in the form of government purchase services to participate in the service of basic medical insurance，Controlling Urban and Rural Residents' Disease Insurance，Introduction to the competition mechanism，Improve the efficiency and quality of management service management services for medical insurance。Encourage the development of commercial health insurance。

 

   (4) Promote the separation of political affairs、Separation of Management Office，Establish a modern hospital management system

 

  11. Stimulate the government's medical system.

 

  All places should adapt to local conditions，Explore effective organizational form，Coordinating the responsibility of governing government medical treatment。

 

  12. Implement the autonomy of the operation and management of public hospitals.

 

  Change government functions，Administrative authorities at all levels have transformed from direct management of public hospitals to industry management，Strengthen policy and regulations、Industry Plan、Standard specifications and regulatory duties。Improve the legal person governance structure of public hospitals，Implement internal personnel management、Institutional settings、Income allocation、Deputy job recommendation、Middle -level cadres' appointment and removal、Annual budget execution and other autonomy。Improve the internal decision -making and restriction mechanism of public hospitals，Strengthening the public officer，Give full play to the functions of the staff congress，Strengthen democratic management。

 

  13. Performance assessment of public hospitals.

 

  Establish a public welfare -oriented assessment and evaluation system，Highlight function positioning、Responsibility performed、Social satisfaction、Cost control、Operating performance、Financial Management and other indicators。Regularly organize public hospital's performance assessment and the dean's annual and term target responsibility assessment。Assessment results and hospital fiscal subsidies、Medical Insurance Pay、Total performance salary and dean's salary、Appointment and removal、Reward and punishment and other hooks，Establish an incentive constraint mechanism。

 

  14. Strengthen the refined management of public hospitals.

 

  Improve the medical quality and safety management system，Improve quality monitoring and evaluation system，Promoting clinical path management，Promoting continuous improvement of medical quality。Implement comprehensive budget management，Carry out cost accounting，Comprehensive analysis of income and expenditure、Budget execution、Cost efficiency and debt repayment capacity, etc.，An important basis for the management decision -making of the hospital。Implementing a third -party accounting audit supervision system，Strengthen state -owned assets for hospitals、Supervision of economic operation。

 

   (5) Establish a personnel salary system that is in line with the characteristics of the industry，Mobilize the enthusiasm of medical staff

 

  15. Establish a flexible mechanism for use.

 

  Innovative public hospital preparation management method，Perfect the management measures，Actively explore the pilot management reform of public hospital preparation and management。In the total number of preparations in the local area，Determine the total number of public hospitals，Gradually implement the filing system，Carry out preparation management reforms in some large and medium -sized cities third -level public hospitals，Pilot management pilot management pilot。Implementing the employment system、Job Management System、Public recruitment system and other personnel management systems。Simplified recruitment procedures for professional and technical personnel，Professional and technical personnel or high -level talents who are scarce in the hospital can be recruited by the hospital in accordance with regulations。Increases the grass -roots medical and health institutions、Advanced job ratio，Greed up the career development space of medical personnel。

 

  16. Promote the reform of the salary system.

 

  Local can be combined with actual，Make a reasonable determination of public hospital salary levels in accordance with relevant regulations，Gradually increase the proportion of business expenditures in business expenditure。More labor outside working hours、High -level medical talents gather、Public My stake betting appstake online sports bettingwelfare target tasks are heavy、Public medical institutions that develop family doctors' contract services，Tilled when verifying the total performance salary。Strengthen long -term incentives for medical staff，Establish a public welfare -oriented performance assessment mechanism，Salary achieves moderate growth on the basis of maintaining the existing level。Public medical institutions independently allocate performance salary based on the total performance salary approved by the approved performance salary。The total salary verification and the distribution of personal performance salary are not with the medicine of medical institutions、Consumption、Large -scale medical examination and other business income linked，Salary distribution reflects the technical content of the post、Risk、Contribution, etc.，It is strictly forbidden to set up an index for medical staff。Grass -roots medical and health institutions can extract employee welfare funds and reward funds。

 

   (6) Take a family doctor's contract service and medical consortium as an important starting point，Accelerate the construction of the hierarchical diagnosis and treatment system

 

  17. Promoting family doctors signing services.

 

  Formed a family doctor as the core、Specialist provided by a specialist with technical support team，Provide residents with long -term and continuous basic medical care、Public Health and Health Management Service。Optimized signing service connotation，Medical、referral、medication、Medical Insurance and other aspects to implement differentiated policies for the signing residents，Promote the first diagnosis of the grassroots。Improve the performance assessment system based on standardized workload。Can guide residents or families while signing with the family doctor team，Volunteer choosing a second -level hospital、A third -level hospital，Establishing & ldquo; 1+1+1 & rdquo; combined signing service mode，Signing residents can choose a medical institution for a medical institution in the contract group，If you go to the group, you must refer it by a family doctor，Guide residents to change medical habits，Forms a reasonable medical order。

 

  18. Formed a medical consortium.

 

  According to the government led、Volunteer combination、Regional collaboration、Principles that facilitate the masses，Taking resource sharing and talent sinking，Establish a vertical consortium of medical resources，Improve grassroots service capabilities。Determine urban three -level hospitals in the medical consortium、The responsibility relationship between the secondary hospital and the grassroots medical and health institutions，Sign a two -way referral agreement，Improve relevant management、Operation and assessment mechanism。Promoting grass -roots health technicians in the county Guanxiang、Township Guan Village，Establish a talent flexible flow mechanism，Take turns to grass -roots service。Increase the intensity of the counterpart assistance，Precisely assisting grass -roots medical and health institutions specialty construction and talent training，Promote the balanced allocation of urban and rural medical resources。Relying on counterpart support channels，Integrated medical resources，Increase the old revolutionary district、Ethnic area、Frontier area、Support for medical and health care in poor areas，Further do a good job of medical talents & ldquo; group style & rdquo;。

 

  19. Give full play to the advantages of Chinese medicine services.

 

  Strengthen the construction of the Chinese Medicine Museum of Primary Medical and Health Institutions，Promote the comprehensive service mode of Chinese medicine，Extensive promotion and use of Chinese medicine appropriate technology，Give full play to the common disease of Chinese medicine、The role of multiple diseases and chronic disease prevention。In improving the price of traditional Chinese medicine medical services、Based on the value of the labor service of Chinese medicine，Reasonable determination of Chinese medicine to pay according to the disease type。Not sound for the grass -roots Chinese medicine service system、Regional with weak ability，Increase the clinics of traditional Chinese medicine hospitals in traditional Chinese medicine diagnosis and treatment services in the first diagnosis，Meeting the needs of the people first diagnosis to see Chinese medicine。Innovative Chinese medicine diagnosis and treatment mode。

 

  20. Improve the policies of hierarchical diagnosis and treatment supporting policies.

 

  Reasonable division and implementation of medical institutions at all levels，Clear referral procedures and standards，Implement the first consultation system and referring approval responsibility system。Give full play to the regulating role of medical insurance policy，The medical institution implements the responsibility and refer of the diagnosis and referendum and the performance assessment and the medical insurance fund allocation。Exploring the division of cooperation models of medical consortia for vertical cooperation implements the total medical insurance payment for the division of labor，Guide two -way referral。Improve the medical insurance differentiation payment policy of different levels of medical institutions，Promote the first diagnosis of the grassroots。For patients who referred in accordance with the prescribed regulations，Give a tilt in the medical My stake betting appStake Sports Bettinginsurance reimbursement policy。

 

   (7) Make full use of Internet technology，Improve the medical experience of the masses

 

  21. Strengthen the construction of health information infrastructure.

 

  Construction of interoperability sharing、State of business collaborative、Provincial、City、County Fourth Population Health Information Platform，Improve the residential electronic health file、Electronic medical records、Electronic prescriptions, etc. as the core database，Open all kinds of medical and health institutions data resource sharing channels，Improve Internet -based、Hierarchical diagnosis and treatment information system for big data technology，To achieve continuous、Collaborative、Integrated medical and health services provides technical support。

 

  22. Vigorously promote the benefit of the people and benefit the people.

 

  Optimized diagnosis and treatment process，Improve medical treatment environment，Organic arrangements for appointment、Check、Diagnosis and Treatment、referral、Payment settlement and other links，Promoting Internet appointment and division、Mobile payment、Creation of the Clinic、Results query and other applications。Improve the mutual recognition mechanism of inspection results，Apricate high -quality resource radiation effect，It is convenient for the masses to see a doctor nearby。Use mobile client、Internet of Things and other technologies，Building a platform for a doctor and patients，Consultation for health、Patient feedback、Health management provides convenience。Make full use of informationization methods，Provide remote medical services，Priority to open a remote medical system in 834 poor counties。Promoting resident health card、Social Security Card and other applications integrated，Activate residents' electronic health file application，Strengthen the connection of military information、Interconnection，Promoting prevention、Treatment、Integrated electronic health services of rehabilitation and health management。Reasonable deployment of medical resources，Scientific arrangement of the number of doctors from each major，It is guaranteed that the doctor has enough diagnosis time，Improve the quality of medical services。

 

   (8) Develop and regulate social medical doctors，Meet the needs of diversified medical services

 

  23. Improve the development level of social medical treatment.

 

  Regional health planning and medical institution setting planning to leave enough space for social medical treatment，Priority to hold non -profit medical institutions。Optimize the development of medical development for social medical，Promoting non -public medical institutions and public medical institutions in the market、Social insurance fixed point、Key Specialty Construction、Professional title evaluation、Academic Exchange、Level review、Technical access and other aspects of the same treatment。Support social medical chain operation、Establish a brand、Group Development，Provide high -end services and rehabilitation、Senior Nursing and other shortfluous services。Encourage social forces to establish independent medical tests in accordance with relevant regulations、Medical Image Diagnosis、Disinfection supply and blood purification agency。

 

  24. Strengthen standardized management.

 

  Promotion of grounding management，Strengthen the supervision of the entire industry，Unified planning for all medical institutions、Unified accuracy、Unified supervision，Regulate the practical behavior of socially run medical institutions in accordance with the law。Strict cracking down on illegal medicine。According to & ldquo; decentralized service & rdquo; Reform related requirements，Streaming and optimizing the approval access for approval，Strengthen the supervision of the event。Strengthen the property rights of non -profit social medical institutions、Financial Operation、Supervision and Management in the use of funds for balance，Promoting the healthy development of social medical treatment。